DESCRIPTION: (Applicant's Description) The proposed study entitled, The Quality of Life (QOL) of Older Adult Long-term Cancer Survivors, has as its primary aim to determine the physiologic, psychologic, and social long-term effects of surviving cancer on older adults (age 60+). This study uses the general stress and coping paradigm and combines the perspectives of extreme stress theory and identity theory to examine the effects of cancer among a uniquely vulnerable group of survivors: older adults. The physiologic outcomes include indicators for assessing the QOL of older adults, such as physical and cognitive functioning and their appraisal of their physical health and symptoms; psychological outcomes include a global indicator of well being/life satisfaction along with measures of psychological distress (e.g., anxiety and depression) and symptoms of post-traumatic stress disorder (PTSD). In addition, several cancer specific measures of psychological QOL will tap fear of recurrence and stigma. Social QOL outcomes include effects on survivor's identity relevant characteristics, such as self-esteem and body image, and development of the survivor identity with indicators of a survivor's ability to maintain valued roles. Other core features of the model are personal dispositions, such as coping style and health beliefs, along with proactive behaviors, such as health promotion and marshaling support and how these buffer cancer survivors from the chronic stressors associated with cancer survivorship. Other buffers include social support (e.g., informal support received from family and friends and responsiveness of medical care). Central to the analysis are age-related stressors, such as co-morbid health problems and other negative life events that may exacerbate the stress associated with cancer. We propose a 60-month study using a longitudinal design to collect and analyze three waves of in-person interviews with 360 older adults (60 years of age and older), former patients of the Ireland Cancer Center (ICC) of University Hospitals (UH) of Cleveland. The interview data will be combined with the tumor registry life data for each survivor. The sample will include long-term survivors (5 years beyond primary treatment and currently in remission) and stratify the sample on colorectal (N=120), prostate (N=120), and breast cancer N=120), three of the four most common cancers among older adults and those in the ICC tumor registry. It will over-sample African-Americans (N=180) to provide maximum analytic power to identify racial differences. The ICC of UH is one of 12 National Institutes of Health (NIH) Clinical Cancer Centers with data on 25,500 cancer patients diagnosed and/or treated at University Hospitals of Cleveland since 1975. Multivariate analysis, such as regression and structural equation modeling, and growth curve analysis will be used to investigate the relationship between the variables in our conceptual model. Specific comparative analyses are planned with age, gender, and racial subgroups.